INFLUENCE OF CULTURAL BELIEFS ON THE ACCEPTANCE OF THE HPV VACCINE IN NIGERIAN COMMUNITIES

CHAPTER ONE INTRODUCTION 1.1 Background of the Study The World Health Organization (WHO) has identified vaccine hesitancy as a critical threat to global health. This phenomenon is defined as the intentional delay or outright refusal to receive vaccines, even when they are readily available (WHO, 2019). Although vaccines have proven to be extremely effective in controlling the spread of infectious diseases and in saving millions of lives annually, resistance to vaccination continues to persist among individuals and communities worldwide (Larson et al., 2015). The reasons behind this hesitancy are multifaceted and often include fears surrounding vaccine safety and efficacy, spiritual or philosophical convictions, and a deep-seated mistrust of governmental and healthcare institutions (MacDonald & others). Overcoming resistance to vaccination becomes especially complex in contexts where cultural and linguistic differences exist. In such cases, perceptions of vaccination are often heavily influenced by language limitations, traditional values, and historical experiences (Dubé et al., 2015). One of the most widespread sexually transmitted infections globally is the human papillomavirus (HPV). Certain high-risk strains of HPV have been strongly associated with cervical cancer, which remains a leading cause of cancer-related deaths among women (WHO, 2020). Since cervical cancer ranks as the second most common form of cancer among Nigerian women, HPV vaccination serves as a vital preventive tool (Okunade et al., 2021). Despite the vaccine’s availability and its proven efficacy in minimizing HPV-associated cancers, uptake and acceptance in Nigeria remain low (Ezeanochie & Olagbuji, 2022). A key barrier to vaccine acceptance in Nigeria has been found to be the influence of deeply rooted cultural beliefs (Obi et al., 2023). Nigeria's rich cultural landscape—comprising religious, ethnic, and traditional values—significantly shapes health-related decisions (Oduyoye, 2019). Within some cultural ideologies, vaccines are viewed as foreign substances that disrupt nature’s balance, and preference is often given to traditional medicine and home remedies (Adefuye, 2021). Moreover, religious beliefs heavily affect health behaviors, particularly in areas where spiritual leaders wield considerable influence over community decisions (Ezeanochie & Olagbuji, 2022). For instance, since the HPV vaccine is typically administered before sexual debut, some religious groups interpret it as morally inappropriate, believing it could encourage sexual promiscuity among young girls (Obi et al., 2023). This moral stance often leads to parental reluctance to vaccinate their daughters, for fear of inadvertently promoting early sexual activity. In addition, societal norms heavily influence how people approach health interventions such as immunizations. Social expectations and communal beliefs frequently determine whether individuals choose to vaccinate, as the fear of social alienation for deviating from accepted norms can be significant (Onwuegbuzie & Nwankwo, 2021). In many Nigerian societies, decisions about health are often made collectively and reflect the approval or disapproval of the community rather than individual preferences (Adeniran et al., 2020). As a result, individuals who might otherwise consider receiving the HPV vaccine may refrain due to prevailing cultural taboos or skepticism toward vaccination in general. The issue is further complicated by widespread misinformation and limited awareness regarding the HPV virus and its vaccine. Due to poor health education and the circulation of myths, many Nigerians hold false beliefs about the vaccine, including concerns that it could cause infertility or other severe health issues (Okunade et al., 2021). While healthcare providers and community leaders can play a crucial role in shaping public opinion, many lack proper training in delivering culturally sensitive and accurate vaccine information (Ezeanochie & Olagbuji, 2022). Therefore, to promote vaccine uptake and improve public health outcomes, a deeper understanding of how cultural beliefs impact HPV vaccine acceptance is essential. Accordingly, this study intends to explore how cultural values and ideologies affect the acceptance of the HPV vaccine in Nigerian communities. 1.2 Statement of the Problem The human papillomavirus (HPV) vaccine remains a key preventive measure against HPV-related diseases, especially cervical cancer, which continues to be a significant health concern in Nigeria (WHO, 2020). However, despite its availability and clinical efficacy, the HPV vaccine has not been widely accepted across Nigerian communities, largely due to entrenched cultural ideologies and traditional practices (Okunade et al., 2021). Existing research indicates that misinformation from local leaders, concerns about moral implications like encouraging promiscuity, and perceptions of vaccines as unnatural or foreign interventions are major obstacles to acceptance (Ezeanochie & Olagbuji, 2022). For public health campaigns to be effective, there must be a clear understanding of the specific cultural and religious dynamics that contribute to vaccine hesitancy. In many cases, health choices are made within the framework of spiritual or traditional beliefs, where medical treatments are often met with suspicion or resistance (Obi et al., 2023). These cultural influences can lead to the rejection of the HPV vaccine, despite its proven ability to reduce the incidence of HPV infections and related cancers. Therefore, this research seeks to examine the role cultural beliefs play in HPV vaccine acceptance in Nigerian communities. 1.3 Objective of the Study The general objective of this study is to examine how cultural beliefs influence the acceptance of the HPV vaccine within Nigerian communities. The specific objectives are: i. To determine the level of awareness of the HPV vaccine among members of Nigerian communities. ii. To investigate the role of cultural norms in influencing decisions related to the HPV vaccine. iii. To assess how traditional beliefs shape public perceptions of the HPV vaccine in Nigeria. iv. To offer practical recommendations for enhancing the acceptance of the HPV vaccine in Nigerian communities. 1.4 Research Questions To guide this research, the following questions have been formulated: i. What is the level of awareness about the HPV vaccine among Nigerian community members? ii. How do cultural norms shape health-related decisions regarding the HPV vaccine? iii. In what ways do traditional beliefs influence the perception of the HPV vaccine in Nigerian communities? iv. What strategies can be recommended to improve HPV vaccine acceptance in Nigerian communities? 1.5 Significance of the Study The findings from this research will be valuable to health policymakers and public health practitioners. By identifying the specific cultural and social beliefs that contribute to vaccine hesitancy, the study will provide evidence-based insights necessary for designing targeted health education campaigns that are respectful of cultural values. These culturally adapted approaches are crucial in dispelling myths and reducing resistance, thereby enhancing the success of public health efforts in Nigeria. Furthermore, the study holds academic significance. It will contribute to the existing body of literature, enrich library collections, and serve as a useful reference for future researchers who wish to explore similar topics. 1.6 Scope of the Study This study focuses on understanding the influence of cultural beliefs on HPV vaccine acceptance in Nigerian communities. Empirically, it will explore the level of public awareness regarding the vaccine, analyze how cultural norms affect health decisions, investigate traditional belief systems related to vaccination, and propose recommendations to boost vaccine acceptance. Geographically, the research is limited to Kontagora Local Government Area in Niger State, Nigeria. 1.7 Limitation of the Study As with most academic endeavors, this study faced certain limitations. Key among them were: Time Constraints: Balancing this research with other academic obligations such as attending classes and participating in other academic requirements limited the time available for thorough data collection and analysis. Financial Limitations: The researcher encountered considerable financial demands during the study, including costs related to printing, data collection, sourcing academic materials, and preparing the final report. Limited Access to Materials: Finding relevant literature was sometimes difficult, especially due to the limited availability of previous studies on the specific topic under investigation. 1.8 Definition of Terms Human Papillomavirus (HPV): A prevalent sexually transmitted virus known to cause various health complications, including genital warts and cancers, particularly cervical cancer. The virus is preventable through vaccination. HPV Vaccine: A vaccine designed to protect against the most dangerous strains of HPV, which are linked to cervical and other cancers. It is generally recommended for individuals before they become sexually active. Cultural Beliefs: Shared values, traditions, and norms that shape how individuals in a community perceive and engage with healthcare interventions, including vaccines. Vaccine Acceptance: The readiness or willingness of individuals or groups to receive a vaccine when offered. This is influenced by cultural, social, and systemic factors. Vaccine Hesitancy: A delay or refusal to accept vaccines despite their availability. It often stems from fear, misinformation, cultural influence, or lack of trust. Public Health Intervention: Structured programs or strategies initiated by health systems to promote better health outcomes. These include campaigns, education programs, and immunization initiatives.